Provider Demographics
NPI:1972634913
Name:JONES, LISA ANDREWS (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANDREWS
Last Name:JONES
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4763 US HIGHWAY 70 W
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-9124
Mailing Address - Country:US
Mailing Address - Phone:252-523-9580
Mailing Address - Fax:
Practice Address - Street 1:201 N MCLEWEAN ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-4949
Practice Address - Country:US
Practice Address - Phone:252-526-4232
Practice Address - Fax:252-527-0002
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000787133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered